NPIMap

Organization Active NPI

Mobile Massage, LLC

  • Point of Service
  • Vienna, VA
National Provider Identifier
1447679527
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
0019011159 Issued in VA
Legal business name
MOBILE MASSAGE, LLC
Practice address
307 Maple Ave W
Vienna, VA 22180-4307
Phone
(240) 778-8187
NPI assigned
Apr 16, 2014
Last updated
Apr 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William Quell Patrick Jr., LMT
Title
Massage Therapist
Phone
(240) 778-8187

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 0019011159 VA Primary

Addresses

Primary practice location

307 Maple Ave W
Vienna, VA 22180-4307

Mailing address

307 Maple Ave W
Vienna, VA 22180-4307

National Provider Directory

National Provider Directory
Tax ID family
Agape Behavioral Center72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

307 Maple Ave W
Vienna, VA 22180
Phone (240) 778-8187

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1447679527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 MAPLE AVE W",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 MAPLE AVE W",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804307",
            "telephone_number": "240-778-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MASSAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "QUELL",
        "authorized_official_title_or_position": "MASSAGE THERAPIST",
        "authorized_official_telephone_number": "240-778-8187",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "VA",
            "license": "0019011159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.